Individual
BROOKE WAITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
100 NAVARRE PL STE 5500, SOUTH BEND, IN 46601-1172
(574) 647-5200
(574) 647-5210
Mailing address
3245 HEALTH DR STE 100, GRANGER, IN 46530-1380
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704312169
MI
363L00000X
Nurse Practitioner
Primary
4704312163
MI
Other
Enumeration date
01/12/2023
Last updated
09/05/2025
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